Debate continues over which method we should prefer for the preoperative biliary decompression in cases with hilar cholangiocarcinoma

Excerpt

We read with a great interest the article by Kawakami et al. [1] about the best preoperative biliary drainage methods in the management of patients with hilar cholangiocarcinoma (HCA). The authors compared the outcomes of endoscopic nasobiliary drainage (ENBD), endoscopic biliary stenting (EBS) and percutaneous transhepatic biliary drainage (PTBD) in a total of 128 patients. They noted that drainage tube occlusions with cholangitis were more common in the EBS group. They also found that the patients in the PTBD group experienced serious complications including portal vein injury (8%) and cancer dissemination (4%). Finally, they concluded that the ENBD procedure is the best and most suitable method for the initial biliary decompressive approach for the patients with HCA before the resective surgery procedure. …